摘要
目的探讨核周型抗中性粒细胞胞浆抗体(pANCA)、抗酿酒酵母细胞抗体(ASCA)、抗小肠杯状细胞抗体(GAB)和抗胰腺腺泡抗体(PAB)在炎症性肠病(IBD)诊断和鉴别诊断中的临床价值。方法采用间接免疫荧光法对119例溃疡性结肠炎(UC)、152例克罗恩病(CD)和211例其他肠病患者血清进行4种抗体的测定。结果UC组pANCA阳性率最高,也明显高于CD组和其他肠病组,特异性达91.5%,ASCA阳性率最低。CD组PAB和ASCA阳性率较高,但特异性和阳性及阴性预测值稍低,pANCA阳性率最低。GAB两组没有差异。抗体组合比较显示UC组的pANCA+/ASCA-和pANCA+/PAB-,CD组的PAB+/pANCA-和ASCA+/pANCA-的灵敏度较高,而且特异性和阳性及阴性预测值高于单项检测。其他肠病组的4种抗体也有一定的阳性率。结论UC中pANCA+、pANCA+/ASCA-和pANCA+/PAB-,CD中的PAB+、ASCA+、PAB+/pANCA-和ASCA+/pANCA-在IBD的诊断和鉴别诊断中具有一定的临床价值,尤其是UC的pANCA+/ASCA-特异性较高(93.4%),可作为区别于CD和其他肠病的较好指标。
Objective To investigate the clinical values of perinuclear anti-neutrophil cytoplasmic antibody(pANCA),anti-saccharomyces cerevisia antibody(ASCA),anti-intestinal goblet cell antibody(GAB)and anti-pancreatic antibody(PAB)in the diagnosis and differential diagnosis of inflammatory bowel disease(IBD).Methods An indirect immunofluorescence method was used to determine 4 types of antibodies in the serum of 119 patients with UC,152 patients with CD and 211 patients with other intestinal diseases.Results The pANCA positive rate in the UC group was the highest,which was significantly higher than that in the CD and other intestinal diseases group,with a specificity of 91.5%.The ASCA positive rate was the lowest in the UC group.The PAB and ASCA positive rates in the CD group were higher,but the specificity,negative and positive predictive values were slightly lower.The pANCA positive rate was the lowest in the CD group.There was no difference between two groups in GAB detection.The antibody combination comparison showed that the sensitivity of pANCA+/ASCA-and pANCA+/PAB-in the UC group,PAB+/pANCA-and ASCA+/pANCA-in the CD group were relatively high,and the specificity,negative and positive predictive values were higher than those of single test.The 4 types of antibodies of the other intestinal diseases group also showed certain positive rate.Conclusion Serum antibodies in the UC group(pANCA+,pANCA+/ASCA-,pANCA+/PAB-)and CD group(PAB+,ASCA+,PAB+/pANCA-,ASCA+/pANCA-)have certain clinical values in the diagnosis and differential diagnosis of IBD.In particular,pANCA+/ASCA-in the UC group has a relatively highly specific(93.4%),which can be used as a better indicator to distinguish CD and other intestinal diseases.
作者
毕永春
程守军
陶月
陈军浩
BI Yongchun;CHENG Shoujun;TAO Yue;CHEN Junhao(Department of Clinical Laboratory,Drum Tower Hospital Nanjing University Medical School,Nanjing 210008,China)
出处
《标记免疫分析与临床》
CAS
2020年第9期1495-1498,共4页
Labeled Immunoassays and Clinical Medicine
